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PP > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

Features of chronic inflammation

A

Delayed onset
Variable duration
Variable appearances
Limits damage, initiated repair
Can cause debilitating symptoms

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2
Q

How does chronic inflammation arise

A
  1. Take over from acute inflammation if resolution is not possible with a.i.
  2. Develops alongside acute inflammation
  3. Arises ‘de novo’ - without preceding acute inflammation (e.g. autoimmune conditions)
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3
Q

What does ‘de novo’ mean

A

Without preceding acute inflammation
E.g. autoimmune conditions

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4
Q

What cell types are present in chronic inflammation

A

Macrophage
Lymphocyte
Plasma cell
Eosinophil
Fibroblasts/Myofibroblasts
Giant cells (Foreign body, Langhans, Touton)

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5
Q

Macrophage in circulation is called…

A

Monocyte

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6
Q

Alias for ‘Macrophage’

A

Histiocyte

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7
Q

Appearance of MACROPHAGE

A

Large cells
Abundant, foamy cytoplasm
Slipper shaped nucleus
Contains debris/pigment

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8
Q

Function of MACROPHAGE

A

-Phagocytosis (removal of pathogen)
Antigen presentation to immune system

-Inflammatory Mediators (synthesis and release of mediators)
Controls and regulates inflammatory response

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9
Q

Appearance of LYMPHOCYTE

A

Small cells (slightly larger than RBC)
Spherical nucleus, thin rim of cytoplasm

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10
Q

Function of LYMPHOCYTE

A

T cell:
Helper- assist other inflammatory cells
Cytotoxic- destroys pathogens

B cell: Mature into plasma cells
Produced antibodies, neutralise pathogens

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11
Q

Appearance of PLASMA CELL

A

Eccentric nucleus
‘Clock-face’ chromatin
Peri-nuclear clearing by Golgi

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12
Q

Function of PLASMA CELL

A

Fully differentiated B lymphocyte
Produces antibodies

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13
Q

Appearance of EOSINOPHIL

A

Bi-lobed nucleus
Granular cytoplasm- stains RED

‘Tomato with sunglasses’

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14
Q

Function of EOSINOPHIL

A

Release of a variety of mediators

Hypersensitivity reactions (e.g. asthma)
Parasitic infection

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15
Q

Features of FIBROBLAST/MYOFIBROBLAST

A

Regeneration and repair

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16
Q

Types of GIANT CELLS

A

Foreign body giant cell
Langhans giant cell
Touton giant cel

17
Q

Features of GIANT CELLS

A

Multinucleate cells
Fusion of multiple macrophages

‘Frustrated phagocytosis’

18
Q

Features of FOREIGN BODY Giant cells

A

-Random scattering of nuclei

-Foreign body in the middle
E.g.) suture

19
Q

Features of LANGHANS Giant cell

A

-Nuclei around the outside
-Horseshoe pattern
-Can be seen in tuberculosis

20
Q

Features of Touton Giant cell

A

-Nuclei in the middle of cell
-Seen in fat necrosis

21
Q

Effects of chronic inflammation

A

Fibrosis (deposition of collagen), e.g. liver cirrhosis

Impaired function, e.g.inflammatory bowel disease

Atrophy, e.g. atrophic gastritis

Stimulation of immune response

22
Q

Explain fibrosis

A

Thickening / scarring of tissue

In liver…
Repeated obstruction of bile duct by gall stones

23
Q

What is an impaired function as an effect of chronic inflammation

A

Idiopathic inflammatory bowel disease
-abdominal pain
-altered bowel motion
-weight loss
-rectal bleeding

24
Q

What are the two idiopathic inflammatory bowel diseases

A

Crohn’s Disease
Ulcerative Colitis

25
Q

Difference between ‘Crohn’s Disease’ and ‘Ulcerative Colitis’

A

Crohn’s Disease:
-can affect all of GI tract
-‘skip lesions’
-inflammation affects FULL THICKNESS OF BOWEL WALL
-granulomata
-less likely to have rectal bleeding

Ulcerative Colitis:
-affects LARGE BOWEL only
-continuous inflammation
-inflammation affects SUPERFICIAL BOWEL WALL only (mucosa, submucosa)
-no granulomata
-more likely to have rectal bleeding

26
Q

Describe cirrhosis

A

End stage damage to liver
Due to alcohol, hepatitis, drugs & toxins

27
Q

Features of GRANULOMA

A

-A collection of epithelioid histiocytes (macrophages that look like epithelial cells)
-Surrounding histiocytes

28
Q

Types of granuloma

A

Foreign Body:
-destruction and removal of FOREIGN MATERIAL
-few lymphocytes

Immune Mediated:
-destruction and removal of PATHOGENS
-can be idiopathic
-undergoes central necrosis
-many lymphocytes

29
Q

Cause of granulomatous inflammation

A

Foreign body reaction
Infections (e.g. mycobacterium tuberculosis/leprae)

PP (15 decks)

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